目的　观察并分析阻塞性睡眠呼吸暂停低通气综合征（OSAHS）鼻、咽联合手术围手术期咽腔间距解剖变化的规律，及其对术后治疗、气管切开术选择的临床指导意义。  方法　选择确诊为鼻、咽多平面狭窄的OSAHS患者50例，全麻下行改良悬雍垂腭咽成形术、鼻腔扩容术和/或鼻咽部腺样体切除术。测量术前清醒坐位，术前全麻卧位，术后全麻卧位，术后第1、2、3 d清醒坐位的咽腔间距，并记录术后当晚最低血氧饱和度和平均血氧饱和度，观察有无并发症。  结果　术后第1、2、3 d坐位时咽腔各间距测量值均大于术前坐位值，软腭长度小于术前。全麻术前卧位咽腔间距小于清醒坐位。全麻术后卧位咽腔间距大于全麻术前卧位。术后当晚平均血氧和最低血氧饱和度均高于术前。术后无呼吸困难、无术区出血，未行气管切开术。  结论　OSAHS鼻、咽部多平面联合手术术后气道得到明显扩张，未出现急性梗阻及渐进性狭窄所致呼吸困难。在严格把握适应症及密切监护的前提下可不行气管切开术。

Objective　To analyse improvement of pharyngeal cavity spacing and ventilation during perioperative period of combined surgery on palatopharyngeal region and its upper level for obstructive sleep apnea hypopnea syndrome (OSAHS) patients，and explore its clinical significance on  postoperative treatment and screening tracheotomy indication.　Methods  50 OSAHS patients, whose obstruction location were analyzed by apneagraph, nasopharyngeal 3D-computed tomography, electronic nasopharynlaryngoscope，modified uvulopalatopharyngoplasty （UPPP）、endoscopic nasal dilatancy surgery、adenoidectomy,were included in this study. pharyngeal cavity spacing was measured before operation, after general anesthesia、, after operation and in the consecutive three days. Lowest SaO2、average SaO2、 complication were recorded.　Results　After operation, pharyngeal cavity spacing was expanded , and Soft palate length was shortened .In the 12 hours after operation, Lowest SaO2 and average SaO2 increased remarkably. No dyspnea and bleeding were observed, and all patients were exempted of tracheotomy.　Conclusions　Upper airway of OSAHS patients who received UPPP and nasal/nasopharynal combined surgery was widened obviously after operation, with the blockage improved and SaO2 increased accordingly. Acute or chronic obstruction does not appear after three days of operation. Tracheotomy can be avoided when indication and intensive care are under control.